In the medical field, there is substantial use of what are called "endoscopic instruments" which essentially are tubelike devices which are inserted into a human body, or the body of an animal through an orifice whereby the interior of the body can be explored and in some instances operated on without the usual procedure of cutting into the body.
These instruments can be manipulated from outside the body whereby the instrument is guided into various sections internally, and observations can be made through the tubelike instrument. In some instances, auxilliary devices are used to cut, scrape, obtain biopsy specimens and the like. Encoscopes are very expensive, delicate and precise instruments, needing care in handling and cleaning to prevent damage. Moreover, as these instruments are used in internal areas of the body, extra care should be taken to prevent contamination and spread of infectious diseases such as hepatitis or typhoid, or contaminants such as salmonella.
The operator, after withdrawing the instrument from the human or animal body, must clean the instrument since the instrument generally has undesirable accumulations thereon such as feces or mucous or other body fluids or solids.
The instruments being relatively long, for instance 36" or more in length, and of a flexible, wiry construction pose a problem for cleaning in that if the device is placed under a running faucet, for instance, there is a real problem of proper maniuplation under the faucet. Also, there is a need for some type of abrasion on the surface to remove solids or fluids that adhere thereto, and it is very difficult while holding the instrument for the operator to also manipulate a cleaning instrument on the surface, such as a brush or wash rag or the like.
In other instances, a pool of water is accumulated in the sink and the instrument is immersed. Some cleaning utensil such as a scrub pad is worked over the surface.
Where there is great and constant use of many instruments, there is now a machine which has a compartment therein where the instrument is coiled and placed. A complicated sonic type of cleaning is then imparted to the instrument within the compartment. The machine is extremely expensive and requires a substantial capital investment.
As set forth above, the problems include the difficulty of efficient and proper cleaning wherein the instrument must be maniuplated and scrubbed at the same time. Additionally, there is a real danger that immersion into a body of water can harm the sensitive endoscope mechanisms and head which has very delicate fiberoptics therein.
Where a machine is used, there is a huge capital investment which is not warranted or possible where, for instance, individual practitioners work on a less busy basis than where many instruments are being used.
Quite commonly in the past, a 4.times.4" gauze pad has been used to clean and prepare the instrument because these pads are available and handy. Sponges, too, have been used but these materials have a strong bias to move away from the tube to be cleaned. A folded sponge is adequate to clean an endoscope tube only if the person exercises great care to ensure that the abrasiveness of the sponge surface is held against the tube and is maintained against the tube to contact the entire surface of the tube. This means often times that two hands are needed to clean the tube, plus another hand to hold the control portion. The technician faces a "no-win" choice between loss of time, damage to the equipment, and incomplete cleanliness.
A survey of over thirty hospitals reveals that currently there is a hodge-podge of cleaning processes and apparatus. Included are gauze pads and liquid soaps and detergents. These soaps and detergents have very poor bacteriacidal action.
It is known what should be done to obtain proper cleaning. The procedure should include the use of certain chemicals which should be applied to the entire device and there should be suitable abrasion or other rubbing action to apply this chemical.
Coker et al U.S. Pat. No. 3,447,181 discloses a surgical scrub device of rectangular shape, although no advantage of this shape is disclosed except that the sponge portion fits the brush portion and can be filled with detergent during manufacture. In actual use, the sponge portion releases liquid and detergent when squeezed, but unless the backing of the brush is porous (which it is not taught to be), none of this cleansing solution is directly applied to the device being scrubbed. Moreover, when the sponge portion is used in direct contact with the object to be scrubbed, the brushes must be grabbed, leading to awkward or uncomfortable problems. The same design is shown in Design Pat. No. 211,851.
While Coker et al and other designs might be of value for some purposes, they are not suitable for use by an operator who must hold the object being cleaned in one hand and thoroughly and totally contact the object with a cleaning device with the other hand.
Of course, prior art methods of placing the instrument in a bath suitably designed to prevent damage to the instrument, followed by hand scrubbing with conventional cleaning equipment including sterile surgical sponges, can be carried out. The instrument will be protected and cleaned. At the same time, valuable time in the operating room will be lost, since although time is of the essence in the operating room, sanitation and antiseptic conditions are the first order of priority. Additional expense in providing extra equipment and/or additional personnel is another cost added to the loss of time when conventional cleaning equipment is used. Use of the device away from fully equipped hospitals is also limited without improved cleaning techniques.
Accordingly, it would be of great benefit to users of endoscopic instruments, and therefore to the patients receiving the treatment, if a self-contained cleaning device could be developed which would permit safe, fast, thorough cleaning without expensive equipment and with a minimum amount of effort.